Basic Information
| Provider Information | |||||||||
| NPI: | 1891171120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRINH | ||||||||
| FirstName: | HOANG | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 WOODLAND ST | ||||||||
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| City: | WINDSOR | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060953455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608100984 | ||||||||
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| Practice Location | |||||||||
| Address1: | 117 PARK AVE | ||||||||
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| City: | WEST SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010893326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135842173 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2015 | ||||||||
| LastUpdateDate: | 08/10/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA5481 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.